WOMEN SUPPORTING WOMEN: PEER SUPPORT GROUP FOR OLDER WOMEN WITH METASTATIC BREAST CANCER IN NIGERIA

Abstract Metastatic breast cancer (mBC) is incurable and devastating to all cancer patients. In Nigeria, the proportion of patients with stage III or IV/metastatic breast cancer at diagnosis is 98%. Although many younger mBC patients live for years, older mBC patients have poorer prognosis, more physical symptoms, poorer access to palliative care, and experience higher social isolation. Also, most older Nigerian women diagnosed with mBC experience psychological challenges during and after their treatment, with higher possibility of abscondment from treatment. While peer support groups (PSG) have become increasingly beneficial for improving the quality of life (QoL) of these older women, there is paucity of literature exploring the benefit of these groups and how they provide support to cancer patients in Nigeria. Using a qualitative research approach and interpretative phenomenological analysis, we explored the experiences of older Nigerian women (n=8) living with mBC who belong to a PSG. Our finding shows that for older women living with mBC, seeing peers with similar lived experiences inspire them to keep living, being hopeful, and experience a reduction in death anxiety. PSG provides a culture of love, peer support, socialization and strengthened connections. In addition to pain and inability to walk (mBC linked disabilities) being recurring physiological challenges for many older women with mBC, forced retirement/inability to work, death anxiety, financial burden, and limited access to cancer care are some of the socio-psychological challenges they face. Therefore, the establishment of PSG in cancer treatment centers in Nigeria would improve QoL and reduce abscondment from treatment.

biomarkers with upper and lower extremity strength among adults without T2DM at baseline.Participants were 1,572 African American (AA) and White adults (M(SD) age at baseline = 47.3 (9.7) years, 55% female, 53% AA) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, assessed on up to 3 time points between 2004-2017.Participants provided blood samples for measurement of fasting glucose and glycosylated hemoglobin (HbA1c), and completed dominant and nondominant handgrip strength assessment, and a chair stands task to assess upper and lower extremity strength, respectively.Linear mixed effects regression models estimating relations of HbA1c on age-related change and adjusting for race, sex, literacy, and poverty status revealed significant four-way interactions of HbA1c, race, sex, and age (B = -.2.59, t(2853) = -2.0p = 0.04), and to a lesser extent of fasting glucose, race, sex, and age (B = -.07,t(2863) = -1.84p = 0.06) on change in the chair stands task, but not on handgrip strength (ps > 0.29).Among younger AA and White men, and younger White women, increasing HbA1c was related to worse lower extremity strength.However, among AA women, and older White women, increasing HBA1c was related to better lower extremity strength.Our findings suggest differential relations of worse glucose regulation on physical functioning amongst African American and White men and women.Nsukka,Nsukka,Enugu,Nigeria,3. SMILE With Me Foundation,Lagos,Lagos,Nigeria,4. The Psych Lounge,Hoschton,Georgia,United States,5. University of Connecticut,Storrs,Connecticut,United States,6. National Hospital Abuja,Abuja,Federal Capital Territory,Nigeria,7. University of Kentucky,Lexington,Kentucky,United States Metastatic breast cancer (mBC) is incurable and devastating to all cancer patients.In Nigeria, the proportion of patients with stage III or IV/metastatic breast cancer at diagnosis is 98%.Although many younger mBC patients live for years, older mBC patients have poorer prognosis, more physical symptoms, poorer access to palliative care, and experience higher social isolation.Also, most older Nigerian women diagnosed with mBC experience psychological challenges during and after their treatment, with higher possibility of abscondment from treatment.While peer support groups (PSG) have become increasingly beneficial for improving the quality of life (QoL) of these older women, there is paucity of literature exploring the benefit of these groups and how they provide support to cancer patients in Nigeria.Using a qualitative research approach and interpretative phenomenological analysis, we explored the experiences of older Nigerian women (n=8) living with mBC who belong to a PSG.Our finding shows that for older women living with mBC, seeing peers with similar lived experiences inspire them to keep living, being hopeful, and experience a reduction in death anxiety.PSG provides a culture of love, peer support, socialization and strengthened connections.In addition to pain and inability to walk (mBC linked disabilities) being recurring physiological challenges for many older women with mBC, forced retirement/inability to work, death anxiety, financial burden, and limited access to cancer care are some of the socio-psychological challenges they face.Therefore, the establishment of PSG in cancer treatment centers in Nigeria would improve QoL and reduce abscondment from treatment.

DONALD P. KENT AND ROBERT W. KLEEMEIER AWARD LECTURES Chair: James Nelson
The Donald P. Kent Award lecture will feature an address by the 2022 Kent Award recipient Nancy R. Hooyman, PhD, FGSA, of the University of Washington.The Kent Award is given annually to a member of The Gerontological Society of America who best exemplifies the highest standards of professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society.The Robert W. Kleemeier Award lecture will feature an address by the 2022 Kleemeier Award recipient Sheryl Zimmerman, PhD, FGSA, of the University of North Carolina at Chapel Hill.The Kleemeier Award is given annually to a member of The Gerontological Society of America in recognition for outstanding research in the field of gerontology.

CARE JUSTICE FOR UNPAID AND UNDERPAID CARE WORKERS Nancy Hooyman, University of Washington, Seattle, Washington, United States
Scholarship on older women, family caregiving, feminist gerontology, community-based services and policy change intersected throughout my career.As a social worker, care of older adults has always been a matter of social justice.My focus now is on care justice for those who perform the critical work of long-term services and supports: unpaid family caregivers and underpaid home care workers.This lecture will examine the interrelationships among both types of care laborers, who often face structural constraints on their decision to care and whose work is devalued, marginalized and invisible.Inequities for care workers by race, immigrant status, and sexual orientation are rooted in systemic racism, sexism, xenophobia, and homophobia.This lecture presents the components of a care justice framework, informed by feminism, intersectionality, and care theory, of fundamental structural changes to value collectively the essential work of care, ensure meaningful choice to care, and reduce inequities in care labor.

UNIVERSITY KENAN DISTINGUISHED PROFESSOR AND CO-DIRECTOR, PROGRAM ON AGING, DISABILITY, AND LONG-TERM CARE Sheryl Zimmerman, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
The concept of person-centeredness --simply stated, knowing the person in a holistic perspective and meeting the individual's needs and preferences --has become so ubiquitous in health and supportive care that it borders on being a cliché.More so, it is often not reflected in national surveys and databases; considered in relation to the capacity of varying systems of care; forward-thinking in terms of emerging realities; or dissected in reference to some of the nuanced and implicit issues responsible for bringing it to the forefront of national attention.This Kleemeier Award lecture will reconstruct the concept of person-centeredness based on literature review, questionnaires, interviews, forums, and think tank meetings with diverse experts.It is supported by National Institute of Aging through a grant to the Alzheimer's Association's LINC-AD.

OLDER ADULTS' USE OF HOME AND COMMUNITY-BASED SERVICES: INDIVIDUAL ATTRIBUTES AND LOCATION DISPARITIES
Chair: Karen Roberto Co-Chair: Tina Savla Home and Community-Based Services (HCBS) are designed to support older adults with functional and cognitive limitations.Yet, use of services is low, gaps exist in service provision, and available services do not always meet the person's need.This symposium focuses on idiosyncrasies surrounding HCBS use.Nah and colleagues identify individual (income, ADL limitations, informal support) and countylevel (poverty and public spending on services) factors associated with HCBS use among persons living with dementia in rural Appalachia.Shippee and colleagues' examination of services received/desired indicates that older adults who are Black/other race/ethnicity were more likely to receive ADS; individuals living with AD/ADRD consumed personal care services at the highest proportion.Cheng's and Li's assessment of generosity in supporting HCBS reveals that while overall state support for HCBS has increased, Medicaid and OAA programs expenditures for services varies substantially across states.Fortinsky and colleagues' examination of risk factors for emergency department use among older adult Medicaid HCBS users shows use was associated with high school education, more severe depressive symptoms, and more chronic conditions; non-Hispanic Asian individuals had the lowest likelihood of use.Konetzka and Wang provide national evidence that use of Medicaid HCBS influences Medicare post-acute care utilization among the dually enrolled.Collectively, the symposium highlights the importance of taking into consideration individual variations in care needs, local and state support for HCBS, and disparities in healthcare and service use influencing older adults' use of HCBS, and advances understanding of intersecting micro-and macro-level effects on service availability, use, and outcomes.